Lectures on the diseases of the stomach : with an introduction on its anatomy and physiology / by William Brinton.

  • Brinton, William, 1823-1867.
Date:
MDCCCLXIV [1864]
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the diseases of the stomach : with an introduction on its anatomy and physiology / by William Brinton. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    great descent downwards, it comes forwards; so that what was its vertical surface now looks obliquely upwards, while its inferior border touches the lower part of the wall of the epigas- trium, where its artery has even been felt pulsating in very emaciated subjects. In the physical examination of the stomach during life, the accuracy with which the outline of the organ can be mapped out by percussion is, of course, subject to great variations. If tolerably distended, the mere tone afforded by the cardiac end will generally distinguish it from the colon (and a fortiori from the small intestine), no matter how great or irregular the flatulent distension of its adjoining segments. The gradual merging of this deep tympanitic sound into that of intestine, near the pylorus, is a source of less ambiguity than might be expected ; both from the proximity of this part to the surface, as well as from its marked contrast with the liver and colon above and below respectively. Often, however, the latter aid to distinction is absent, from the small or large intestine over- lying the stomach for a longer or shorter period; a state which is, I think, more frequently produced by the segment thus con- cealing this stomach being pushed over by the distension of adjacent parts, than by its own flatulent dilatation. Lastly, a distended cardiac sac can scarcely be outlined with exactness ; its tympanitic resonance being so gradually obscured by the increasingly thick wedge of lung which intervenes between the hypochondriac integuments and the highest (or diaphragmatic) part of this sac, that no definite line of demarcation is generally traceable. In common with all the sub-diaphragmatic segments of the alimentary canal, the stomach is composed of three coats or tunics:—an external and serous, a middle and muscular, and an internal and mucous coat. The first of these attaches the organ to the cavity in which it is enclosed; and limits, permits, and facilitates those movements which it is the chief office of the second to execute. The third is the most important, forming the secreting and absorbing surface on which the functions of the organ chiefly depend. The serous coat of the stomach is continuous with the double laminae of peritoneum before mentioned, which split to enclose